Mol Microbiol, 1991 Jun, 5(6), 1531 - 8 Enhancement of the invasive ability of Neisseria gonorrhoeae by contact with HecIB, an adenocarcinoma endometrial cell line; Chen JC et al.; Since Neisseria gonorrhoeae is an obligate pathogen, there is no animal model for identification of virulence factors for this bacterium . An alternative model for assessment of gonococcal virulence is invasion of the adenocarcinoma endometrial cell line, HecIB . Preincubation of gonococci with glutaraldehyde-fixed HecIB cells eliminated the six- to eight-hour lag in entry of bacteria into a fresh HeIIB monolayer seen with unpreincubated gonococci or gonococci preincubated in tissue-culture medium alone . Gonococci tightly bound to fixed HecIB cells were more invasive than cells free in the tissue-culture medium, suggesting that actual contact with HecIB cells was required for the enhancement of invasive ability . Chloramphenicol addition during the preincubation prevented the enhanced invasion . Preincubated gonococci were not more adherent to HecIB cells, suggesting that a stage in invasion after binding of gonococci to HecIB cells was enhanced . The enhanced invasion occurred only when gonococci were preincubated with HecIB cells and not with HEp-2, HeLa, Chang or CHO cells . This eukaryotic cell specificity for induction of enhanced invasion may indicate a role for invasion in gonococcal infection of the endometrium. East Afr Med J, 1991 Jun, 68(6), 425 - 9 Long distance truck-drivers: 1 . Prevalence of sexually transmitted diseases (STDs); Bwayo JJ et al.; A cross section study was conducted among long distance truck drivers to determine the prevalence of sexually transmitted diseases (STDs) and antibodies to human immunodeficiency virus (HIV) . A total of 8 drivers and their assistants en route from port of Mombasa to countries in East and Central Africa were enrolled into the study . Blood was taken for HIV and syphilis serology . Discharges from urethra and genital ulcer disease (GUD) were cultured . Seroprevalence for HIV was 18% and 4.6% for syphilis . Fifty percent of Neisseria Gonorrhea cultured were penicillinase producers . Most of the men with urethral discharge and all the GUD were culture negative, probably due to prior treatment . Lack of circumcision, past history of GUD and urethritis were significantly associated with HIV seroconversionPIP: This article reports the findings of a study of HIV and STDs prevalence among long-distance truck drivers from East and Central Africa . Similar to prostitutes, truck drivers and a highly mobile population, characterized by having multiple sex partners . The researchers established a tent clinic at the Athi River Weighbridge Police Station near Nairobi, Kenya, where convoys of trucks stop for 3-5 days . 331 men from several East and Central African countries participated in the study . The participants completed a standard questionnaire about their medical history, knowledge, attitudes, and sex practices, and underwent a physical examination and blood test . Their ages ranged from 18-61 years, with a mean age of 31 years . 18% of the participants tested positive for HIV . Additionally, 4.6% tested positive for syphilis, and 4.5% and 4.3% suffered from urethral discharge ranked as the highest risk factor, followed by lack of circumcision . The study found no difference in the HIV prevalence rate between married and single men . The prevalence rate was far higher among Central Africans (31.75%) than among East Africans (16.65%), possibly explained by the hypothesis that says that HIV was first introduced in Central Africa, from where it spread to East Africa . Older drivers where more likely to be infected with HIV than younger drivers, with the age group of 40-49 having the highest prevalence rate . Researchers suspect that this is due to the fact that older drivers have been exposed longer and have more money with which to purchase sex . The report concludes that truck drivers constitute a high risk group, and should be targeted accordingly, with education and condom use campaigns . P N G Med J, 1991 Jun, 34(2), 149 - 54 The diagnosis and management of common forms of arthritis in adults in Papua New Guinea; Richens J; Reactive arthritis is the leading cause of arthritis in Papua New Guinea, followed probably by gonococcal arthritis . Indomethacin and local hydrocortisone acetate are useful in the treatment of reactive arthritis . Refractory cases of reactive arthritis may be helped by weekly low-dose oral methotrexate or by long courses of doxycycline . When Neisseria gonorrhoeae is thought to be involved treatment should cover penicillinase-producing strains . Infective arthritis due to Staphylococcus aureus and Mycobacterium tuberculosis is less common but should be considered in all patients because prompt and specific treatment is required to avoid permanent damage. Bull Acad Natl Med, 1991 Jun-Jul, 175(6), 823 - 34 {Molecular bases of virulence in Neisseria gonorrhoeae}; Marchal C et al.; Gonorrhea remains of clinical concern, due to its frequency, complications, sequelae, increasing prevalence of antibiotic-resistant strains and absence of vaccine . A better understanding of the first stages of infection as well as of mechanisms of escape to immune response appears important . Many pathogenic bacteria express pili on their all surfaces . These structures mediate binding of bacteria to host tissues . Furthermore, gonococcal pili are submitted to a high rate antigenic variation, allowing the escape to host immune response . Pilin antigenic variation occurs by DNA recombination between one of the silent partial variant gene segments and an expressed pilin genes . We have shown that transformation of living bacteria by DNA liberated from lysed cells is a critical strep for antigenic variation . This constitutes the first specific function for a DNA transformation system . Piliation and virulence can change with culture conditions . This observation suggests that pilin expression would be subjected to an adaptative response . We have identified and characterized two genes which act in trans to regulate pilus expression . They determine synthesis of a response regulator and a membrane located sensor . They appear to regulate expression of other genes, possibly also involved in virulence . We present evidence for several environmental factors which may control the degree of piliation. EMBO J, 1991 Jun, 10(6), 1307 - 15 Phase variation of the opacity outer membrane protein controls invasion by Neisseria gonorrhoeae into human epithelial cells; Makino S et al.; Neisseria gonorrhoeae is a facultative intracellular bacterium capable of penetrating into certain human epithelial cell types . In order to identify gonococcal factors essential for invading Chang human conjunctiva cells, a gentamicin selection assay for the quantification of viable intracellular bacteria was used in conjunction with microscopy . The results demonstrate a correlation between the invasive behaviour of gonococci and the expression of Opa proteins, a family of variable outer membrane proteins present in all pathogenic Neisseria species . However, only particular Opa proteins supported invasion into Chang cells as indicated by the use of two unrelated gonococcal strains . Invasion was sensitive to cytochalasin D, and strong adherence mediated by the Opa proteins appeared to be essential for the internalization of gonococci . In contrast pili, which also conferred binding to Chang conjunctiva cells, did not support cellular invasion but rather were inhibitory. Am J Obstet Gynecol, 1991 May, 164(5 Pt 2), 1396 - 9 The clinical experience with ofloxacin in the treatment of sexually transmitted diseases; Corrado ML; Sexually transmitted diseases are an important cause of morbidity in women . Some of the common causes of sexually transmitted disease include Neisseria gonorrhoeae, Chlamydia trachomatis, and in some patients Ureaplasma urealyticum . N . gonorrhoeae has become more resistant to traditional therapies including penicillin . Resistance to penicillin is mediated by the elaboration of beta-lactamase for most organisms and by chromosomal resistance in others . Resistance to tetracycline and spectinomycin has been clearly identified, as has an increase in the minimum inhibitory concentrations to some cephalosporins . Because of the potential for concomitant infection with N . gonorrhoeae and C . trachomatis, many patients are currently treated with a combination of a single dose of ceftriaxone plus a tetracycline for 7 days . Therefore it is significant that a single agent, ofloxacin, has been introduced recently for the treatment of such mixed infections . It also has the potential for treating N . gonorrhoeae resistant to other drugs. Am J Obstet Gynecol, 1991 May, 164(5 Pt 2), 1390 - 6 A randomized trial of ofloxacin versus cefoxitin and doxycycline in the outpatient treatment of acute salpingitis; Wendel GD Jr et al.; The object of this randomized study was to compare the safety and efficacy of oral ofloxacin, 400 mg twice daily for 10 days, versus intramuscular cefoxitin, 2 gm, plus oral probenecid, 1 gm, followed by oral doxycycline, 100 mg twice daily for 10 days, in the outpatient treatment of uncomplicated acute salpingitis . Thirty-eight women (53%) had Neisseria gonorrhoeae from their pretreatment endocervical or endometrial cultures, and 18 had Chlamydia trachomatis (25%) . Thirty-five of 37 women (95%) treated with the ofloxacin regimen were clinically cured, and 34 of 35 (97%) were cured with the cefoxitin-doxycycline regimen (p = 0.52) . One clinical failure occurred in each group with N . gonorrhoeae infection, and one failure occurred in the ofloxacin group because of side effects . The bacteriologic response for N . gonorrhoeae in both groups was 100% . The eradication of C . trachomatis was 100% (10/10) for the cefoxitin/doxycycline group and 86% (6/7) for ofloxacin . The side effects were similar in both groups of subjects . In this study both regimens were effective for the outpatient treatment of uncomplicated acute salpingitis. Am J Obstet Gynecol, 1991 May, 164(5 Pt 2), 1380 - 3 Effectiveness of ofloxacin in the treatment of Chlamydia trachomatis and Neisseria gonorrhoeae cervical infection; Faro S et al.; Forty patients with cervical infection caused by Chlamydia trachomatis were treated with ofloxacin (20) or doxycycline (20) . Ofloxacin was successful in eradicating C . trachomatis from all 20 (100%) patients . Doxycycline was effective in 18 of 20 (90%) patients . Three patients had a concomitant cervical gonococcal infection . All three were successfully treated: one with ofloxacin and two with doxycycline . Ofloxacin, 300 mg, taken twice daily for 7 days, is effective in eradicating endocervical C . trachomatis infection. Mol Microbiol, 1991 May, 5(5), 1097 - 103 Gonococcal penicillin-binding protein 3 and the surface-exposed 44kDa peptidoglycan-binding protein appear to be the same molecule; Shafer WM et al.; The outer membrane of Neisseria gonorrhoeae contains a 44,000 dalton (44kDa) surface-exposed protein which has the reported ability to form covalent interactions with peptidoglycan (PG) . This PG-binding outer-membrane protein (OMP) appears to be highly conserved since it has been detected in all isolates examined . It also appears to be invariant since its primary structure among strains gives evidence of being identical (Judd et al., 1991) . While studying the interaction of gonococcal penicillin-binding proteins (PBPs) with human lysosomal cathepsin G, we noticed that the 44kDa PG-binding OMP exhibited certain properties similar to PBP3 . In this study we sought to obtain biochemical evidence to ascertain whether these proteins were the same . We found that both proteins fractionated with other sarkosyl-insoluble OMPs and that they exhibited similar susceptibility to cleavage in situ by enzymatically active cathepsin G . Moreover, a purified preparation of the 44kDa OMP was found to covalently bind radiolabelled benzylpenicillin in vitro . Thus, the data presented herein suggest that the 44kDa PG-binding OMP and PBP3 are the same OMP. Mol Microbiol, 1991 May, 5(5), 1091 - 6 Identification and characterization of a conserved outer-membrane protein of Neisseria gonorrhoeae; Judd RC et al.; A previous study in our laboratory identified a surface-exposed peptidoglycan-associated protein of Neisseria gonorrhoeae which had an apparent molecular mass of 44,000 daltons (44kDa) (Hill and Judd, 1989) . This paper reports results which confirm that the 44kDa protein is surface-exposed, and that the protein is expressed in, and is structurally invariant among, 14 strains of N . gonorrhoeae . The fact that the 44kDa outer-membrane protein is found in a conserved form in all gonococci examined strongly suggests that it is crucial to the bacterium's survival . Moreover, it appears that this protein is a penicillin-binding protein (PBP3) (Shafer and Judd, 1991) . This invariant, surface-exposed, peptidoglycan-associated outer-membrane protein deserves further investigation to elucidate its role in the immunobiology of N . gonorrhoeae, and its possible use as an immunoprophylactic reagent. Pathol Biol (Paris), 1991 May, 39(5), 491 - 4 {First isolation in France of a penicillinase-non producing Neisseria gonorrhoeae with high level tetracycline resistance}; Lefevre JC et al.; We report the first isolation in France of a penicillinase-non producing Neisseria gonorrhoeae with high level tetracycline resistance . The minimal inhibitory concentrations (MICs) of nine antibiotics were determined by agar dilution for the tetracycline resistant strain and 39 other penicillinase-non producing N . gonorrhoeae strains which were isolated during the same year (1989), in Toulouse . No difference was observed between the MICs except for the tetracycline (tetracycline-resistant strain MIC = 32 mg/l) . The commonly used antibiotics other than tetracycline were active in vitro against all the strains . The plasmid content of the tetracycline-resistant strain was analysed by agarose gel electrophoresis and revealed the presence of two plasmids: the 2.6-megadalton in cryptic plasmid and the 25.2-megadalton Tet M conjugative plasmid. Can J Microbiol, 1991 May, 37(5), 345 - 9 Transformation of Neisseria gonorrhoeae: physical requirements of the transforming DNA; Stein DC; The 1600-bp (base pair) fragment encoding a portion of the nalidixic acid resistant DNA gyrase, subunit B, was characterized to determine what parameters effect transformation in the gonococcus . When this DNA (pSY2) was isolated from Escherichia coli, it was able to transform a variety of gonococcal strains to resistance to nalidixic acid via DNA-mediated transformation, irrespective of their restriction-modification phenotype . Nalidixic acid resistant transformants contained no plasmid DNA sequences that corresponded to the vector, as measured by plasmid screening procedures and colony hybridization techniques . Supercoiled and linear DNA transformed the gonococcus at the same efficiency . DNA fragments as small as 615 bp were able to transform the gonococcus . The presence of a 10-bp uptake sequence enhanced a DNA fragment's ability to transform the gonococcus by four orders of magnitude . When the fragment encoding the nalidixic acid resistant DNA gyrase was subcloned into M13mp18, both the replicative form and the single-stranded form of the phage were able to transform the gonococcus to nalidixic acid resistance. Pediatr Neurol, 1991 May-Jun, 7(3), 226 - 8 Rhabdomyolysis in children: a 3-year retrospective study; Chamberlain MC; The case reports of 4 pediatric patients illustrate the complex clinical scenarios in which childhood rhabdomyolysis/myoglobinuria occurs . Children ranged in age from 8-18 years . Presumed etiologies of rhabdomyolysis/myoglobinuria included Neisseria sepsis, exertion-related episodes, dialysis disequilibrium, and diabetic ketoacidosis . No child developed respiratory or renal failure . all children were discharged with normal muscle power, indicating the benign nature of this disease and the importance of aggressive management. Eur J Clin Microbiol Infect Dis, 1991 May, 10(5), 405 - 9 Characterization of Neisseria meningitidis serogroup A strains from an outbreak in France by serotype, serosubtype, multilocus enzyme genotype and outer membrane protein pattern; Riou JY et al.; In an attempt to determine the epidemiological relationship between cases of infection caused by Neisseria meningitidis serogroup A in France between August 1987 and December 1988, and an outbreak which occurred in Mecca in August 1987, markers such as serotype, serosubtype, multilocus enzyme genotype and outer membrane protein (OMP) pattern were used to characterize the bacterial isolates . From a total of 28 cases, 20 strains were isolated . Sixteen isolates, including one which undoubtedly originated from the Mecca epidemic, were homogenous (serotype 4, serosubtype P1.9, multilocus enzyme genotype of clone III-1, identical OMP pattern) . Four isolates had a different OMP pattern with little or no P1 protein, no P4 and no P6 . Two of these isolates belonged to other clones (I.1 and group I) and they were considered to be unrelated to the Mecca epidemic strains . The origin of the remaining two isolates was not clear . It is concluded that the majority of the Neisseria meningitidis serogroup A strains recently isolated in France originate from the Mecca epidemic. J Clin Microbiol, 1991 May, 29(5), 883 - 8 Comparison of Gen-Probe DNA probe test and culture for the detection of Neisseria gonorrhoeae in endocervical specimens; Panke ES et al.; A 2-h nonisotopic DNA probe assay for the direct detection of Neisseria gonorrhoeae in urogenital specimens has recently been modified (PACE 2; Gen-Probe, San Diego, Calif.) . The new assay format was developed to increase the sensitivity of the assay and simplify procedural steps . In this study, the new DNA probe test was compared with a culture reference method for the detection of N . gonorrhoeae in endocervical specimens . The results of the DNA probe test were expressed as a ratio of relative light units (RLU) of the specimen/RLU of the cutoff recommended by the manufacturer . All patient samples with sample RLU/cutoff RLU ratios less than 0.7 were interpreted as negative, and ratios greater than 2.0 were interpreted as positive for gonorrhea . Samples with sample RLU/cutoff RLU ratios between 0.7 and 2.0 were repeated until two or more consistent negative or positive ratios were obtained . A total of 469 specimens were tested with an overall disease prevalence of 6.1% . Of the 469 patients tested, 5 specimens (1.0%) fell in this borderline region and were retested . If the manufacturer's recommended cutoff value had been used, the original DNA probe results would have resulted in two false-positives . Our data were analyzed for both symptomatic (prevalence, 11.7%) and asymptomatic (prevalence, 2%) women . The study indicated that with our modification of the manufacturer's endpoint interpretation, the DNA probe test was essentially equivalent to the culture method in terms of sensitivity, specificity, and positive and negative predictive values in both symptomatic and asymptomatic patient populations . The new DNA probe test can serve as a suitable screening and diagnostic test for the diagnosis of gonorrheal genital infections in women . Additionally, it offers the advantages of rapid turnaround time and ease of use and allows simultaneous testing for Chlamydia trachomatis on the same specimen. Infect Immun, 1991 May, 59(5), 1818 - 22 Synthetic peptide substrates for the immunoglobulin A1 protease from Neisseria gonorrhoeae (type 2); Wood SG et al.; Neisseria gonorrhoeae secretes protease which inactive human immunoglobulin A1 (IgA1) by cleavage of specific peptide bonds in the hinge region . The type 2 IgA1 protease (EC 3.4.24.13) is secreted as a 169-kDa precursor which undergoes autoproteolysis at three sites (A, B, and C) to release the 106-kDa active form of the enzyme (J . Pohlner, R . Halter, K . Beyreuther, and T . F . Meyer . Nature {London} 325:458-462, 1987) . Synthetic decapeptides consisting of five residues on each side of the three autoproteolytic cleavage sites and their potential pentapeptide catabolites were prepared by solid-phase synthesis . Cleavage of the decapeptides by the type 2 IgA1 protease from N . gonorrhoeae was monitored by high-performance liquid chromatography . Peptides homologous with the amino acid sequences around the B and C sites are cleaved by the IgA1 protease . Amino acid analysis and Edman degradation show that the cleavage products have both the composition and amino acid sequence which would be expected from cleavage at the predicted sites . Km values of 1.35 mM and 3.43 mM and kcat values of 280 pmol/h/U and 439 pmol/h/U for the site B and site C peptides, respectively, were determined . The catalytic efficiency (kcat/Km) for the synthetic substrates is about 10% of that reported for intact IgA1 . Cleavage of the peptides is inhibited by IgA1 protease inhibitors such as the tetrapeptide substrate analog inhibitor HRP-48, human colostrum, and a peptide-boronate transition state inhibitor . An extract from an N . gonorrhoeae construct lacking active IgA1 protease failed to cleave the synthetic substrate, while an extract from the control construct which secretes active enzyme completely hydrolyzed the synthetic peptide . Neither the site A peptide nor synthetic decapeptides encompassing cleavage sites in the hinge region of IgA1 are hydrolyzed by IgA1 protease . These are the first synthetic substrates to be reported for any IgA1 protease. Eur J Clin Microbiol Infect Dis, 1991 May, 10(5), 443 - 6 Selective medium for isolation of Arcanobacterium haemolyticum and Streptococcus pyogenes; Wat LL et al.; Sheep blood agar using tryptic soy agar base and containing 3.5% sodium chloride was found to facilitate isolation of Arcanobacterium haemolyticum and improve isolation of Voges-Proskauer negative group A (Streptococcus pyogenes) and group C and G beta-haemolytic streptococci . Commensal oropharyngeal flora such as viridans streptococci, Neisseria species, non-haemolytic streptococci and beta-haemolytic streptococci not belonging to groups A, B, C or G were significantly inhibited. Klin Padiatr, 1991 May-Jun, 203(3), 158 - 61 {Tumor necrosis factor in the serum--a useful supplemental parameter in the diagnosis of infection in cystic fibrosis?}; Heininger U et al.; In 15 patients with cystic fibrosis 18 blood samples were investigated for signs of infection including full white blood count, c-reactive protein (CRP) and tumour-necrosis-factor alpha (TNF) . Ten patients were hospitalized for pulmonary exacerbation, one for orthostatic collapse and one for equivalent of meconium ileus . The latter two as well as three out-patients with cystic fibrosis on routine-visits served as controls . Blood was taken on admission and at the time of the visit in our out-patient department, respectively . In three cases, blood was taken repeatedly during their stays in hospital . While leucocytosis (17.700 +/- 3.500) and elevated CRP-levels (6.4 +/- 7.3 mg/dl) pointed to an infectious cause of deterioration in the exacerbation-group, TNF-levels without exception were undetectable (less than 15 pg/ml) . In the control group, leucocyte counts (10.700 +/- 3.600) and CRP-levels (1.2 +/- 1.1 mg/dl) showed minor pathologic results . TNF-levels were undetectable, too . While elevated TNF-levels measured quantitatively in patients with invasive bacterial infections, e.g . septicaemia due to Neisseria meningitidis, correlate well with prognosis of disease, in patients with cystic fibrosis such a relationship can't be found. J Med Microbiol, 1991 May, 34(5), 285 - 93 Stimulation by gonococci of chloride ion uptake in human leucocytes in relation to other properties of phagocytosis; Sukhan A et al.; Human polymorphonuclear leucocytes (PMNL) underwent several changes in response to challenge with Neisseria gonorrhoeae, namely (1) an increase in oxygen uptake, (2) changes in membrane electrical properties, and (3) increased transport of chloride ions (Cl-) across the membrane . Mean oxygen consumption and Cl- uptake by PMNL were stimulated by both pilate (P+) and non-pilate (P-) gonococci, although the levels were much reduced in the presence of P+ organisms . P+ gonococci also initiated low levels of polarisation or depolarisation in contrast with P- cells, which caused hyperpolarisation followed by depolarisation in the PMNL . Most of the strains showed these patterns . High performance liquid chromatography of extracts of unstimulated PMNL and of PMNL challenged with gonococci confirmed production of hypochlorous acid (HOCl) in the leucocyte . Furthermore, addition of radiolabelled Cl- to the PMNLs showed that some of the Cl- taken up by the cells in response to gonococcal challenge was incorporated into the HOCl, suggesting a direct relationship between stimulation of Cl- uptake and production of active chlorine compounds in the leucocyte. Am Fam Physician, 1991 May, 43(5), 1725 - 32 Clinical aspects of pelvic inflammatory disease; Morgan RJ; Pelvic inflammatory disease is caused by spread of organisms from the vagina and cervix to the upper genital tract . The patient may have a life-threatening illness or may remain asymptomatic . The disease may be caused by sexually or nonsexually transmitted organisms . Polymicrobial infections are the rule . Therapy requires antibiotic agents with broad coverage of aerobic and anaerobic organisms, including Chlamydia trachomatis and Neisseria gonorrhoeae. Am J Obstet Gynecol, 1991 May, 164(5 Pt 2), 1370 - 6 Diagnosis and laparoscopic grading of acute salpingitis; Soper DE; Pelvic inflammatory disease continues to be a major cause of morbidity in women of reproductive age . Findings of bilateral adnexal tenderness and signs of a lower genital tract infection (mucopus, or leukorrhea, or both) should prompt clinicians to consider the diagnosis of salpingitis in this group of women . Additional signs of infection, such as elevated temperature, palpable adnexal complex, leukocytosis, elevated erythrocyte sedimentation rate, or c-reactive protein, and positive tests for either Neisseria gonorrhoeae or Chlamydia trachomatis will improve the overall specificity of the clinical diagnosis . Endometrial biopsy offers an acceptable approach to documenting objectively inflammation of the upper genital tract . Diagnostic laparoscopy should be considered in all patients but may be especially helpful for those patients in whom a diagnosis is unclear . A laparoscopic grading system based primarily on tubal mobility and inflammation can be useful in predicting duration of in-hospital therapy and future tubal factor infertility. Rev Sanid Hig Publica (Madr), 1991 May-Jun, 65(3), 247 - 58 {Age and sex distribution of sexually transmitted diseases in Valladolid . A study of 5076 cases}; Orduna Domingo A et al.; The age and sex distribution of 5,076 cases of S.T.D . dealt with between 1982 and 1988 at the Dermatological Dispensary of the Territorial Social Welfare Service in Valladolid are studied . The maximum frequency of S.T.D . (24.1% of cases) corresponded to the age group between 21 and 25 years, which was also the period for maximum prevalence of Neisseria gonorrhoeae (26.3%), Gardnerella vaginalis (30.7%), Candida albicans (27.4%) and acuminata condyloma (33.4%) . Syphilis (19.9%), Chlamydia trachomatis (27%), Ureaplasma urealyticum (24.6%), Mycoplasma hominis (25.0%), Trichomonas vaginalis (23.0%) and genital herpes had maximum prevalence in the group between 26 and 30 years . Women were affected at younger ages than males . 16.9% of women with some S.T.D . were between 16 and 20 years of age, while only 6.5% of males with S.T.D . were in this age-group (p less than 0.001). Microb Pathog, 1991 May, 10(5), 373 - 84 Effect of human chorionic gonadotropin (hCG) on Neisseria gonorrhoeae invasion of and IgA secretion by human fallopian tube mucosa; Gorby GL et al.; The possible effect of human chorionic gonadotropin (hCG) on the mucosal immune response and susceptibility of the fallopian tube mucosa to invasion by Neisseria gonorrhoeae (gonococci) was investigated in the fallopian tube organ culture (FTOC) model . Immunohistochemical and radioreceptor assay techniques showed specific high affinity binding of hCG in vitro to the apices of non-ciliated fallopian tube cells (Kd approximately 10(-9) M) . Continuous exposure of the FTOC mucosa to hCG during infection with gonococci resulted in a marked increase (6- to 15-fold) in IgA secretion and significantly reduced gonococcal invasion (invasion score range 0.7 to 1.75) compared to infected control tissue which was not exposed to hCG (invasion score range 2.9 to 4.95, P less than or equal to 0.01) . By contrast, exposure of the mucosa to hCG during the 24 h preceding gonococcal infection followed by the removal of hCG from the system at the time of infection resulted in enhanced gonococcal invasion (invasion score range 7.95 to 9.7, P less than 0.001) . We conclude that hCG can modulate the mucosal immune response and susceptibility of fallopian tube epithelium to gonococcal invasion. J Clin Pathol, 1991 May, 44(5), 376 - 9 Identification of Neisseria gonorrhoeae using the Neisstrip rapid enzyme detection test; Dealler SF et al.; A rapid enzyme activity strip test (Neisstrip, Lab M Ltd, Bury) was compared retrospectively with Phadebact Monoclonal GC coagglutination (Pharmacia Diagnostics, Uppsala, Sweden), cystine trypticase agar sugar utilisation (CTA), and Gonochek II (J W Turner, Liverpool) enzyme methods for identification of 95 Neisseria spp and related species . These had been previously identified using standard methods and included 29 that had given aberrant results . Neisstrip identified correctly all but two, including nine incorrectly identified by Phadebact and 18 erroneously identified using CTA sugars . Results were similar to those obtained with Gonochek II . After this a prospective study was performed testing 400 oxidase positive isolates derived from clinical samples cultured on gonococcal selective medium . Two organisms, both Moraxella spp, were incorrectly identified as N gonorrhoeae by the Neisstrip . The superoxol test, when used with either the Phadebact or Neisstrip tests, maintained 100% sensitivity and specificity . The Neisstrip is a rapid, economic test that is accurate and easy to interpret . It may be used alone or in conjunction with a superoxol test or a coagglutination test, which is relatively accurate but more expensive, and found by some technical staff to be more difficult to interpret. J Med Microbiol, 1991 May, 34(5), 265 - 70 An epidemiologically valuable typing method for Neisseria meningitidis by analysis of restriction fragment length polymorphisms; Fox AJ et al.; A restriction fragment length polymorphism (RFLP) typing method was developed for Neisseria meningitidis . A cloned EcoRI fragment from a Neisseria meningitidis Group B serotype 15P1.16 sulphonamide-resistant strain was used to probe Southern blots of total chromosomal DNA restriction fragments (enzyme AvaI) . A group of 75 apparently unrelated organisms gave rise to 26 different restriction fragment length patterns and two different groups of epidemiologically related strains had RFLP patterns that were distinct for each group . The technique was highly reproducible and discriminatory . The RFLP data were compared with the results of serotyping and subtyping and isoenzyme electrophoretotyping . The RFLP data were consistent with those from the alternative typing methods; clones defined by isoenzyme analysis were subdivided by this technique . The use of RFLP typing by cloned probes should be of considerable epidemiological value. Proc Natl Acad Sci U S A, 1991 Apr 15, 88(8), 3281 - 5 Product of the Pseudomonas aeruginosa gene pilD is a prepilin leader peptidase; Nunn DN et al.; The related type IV pilins produced by Pseudomonas aeruginosa, Neisseria gonorrhoeae, Bacteroides nodosus, and Moraxella bovis are synthesized as precursors with short, six- or seven-amino acid N-terminal leader peptides . We have previously observed that P . aeruginosa mutations in pilD, a gene required for pilus biogenesis, result in the accumulation of unprocessed prepilin in the membrane and a general defect in the excretion of a number of extracellular enzymes . An endopeptidase activity has been detected in detergent-solubilized inner membrane of P . aeruginosa and shown to correctly cleave the prepilin of P . aeruginosa and N . gonorrhoeae . It is absent from pilD mutants, increased by pilD overexpression, and conferred on Escherichia coli by the introduction of the pilD gene . The pilD gene product, purified by immunoaffinity chromatography with antibody to a PilD-derived synthetic peptide, was identified with the endopeptidase . PilD appears to be a prototype of a class of enzymes that process not only type IV pilin precursors but also components of a protein-excretion apparatus of Gram-negative bacteria. Hinyokika Kiyo, 1991 Apr, 37(4), 441 - 6 {A basic study on cefpirome}; Saito I et al.; The antibacterial activity of cefpirome (CPR), a new parenteral cephalosporin antibiotic having a cyclopentenopyridine group in the 3-position side chain, was evaluated against Neisseria gonorrhoeae and concentrations in human kidney and prostate was determined . The minimum inhibitory concentrations (MICs) of CPR against N . gonorrhoeae isolated clinically in our out-clinic (34 strains of non-PPNG and 20 of PPNG) were less than or equal to 0.003-0.1 microgram/ml in non-PPNG group and 0.006-0.1 microgram/ml in PPNG group . The 90% of MICs (MIC90s) was 0.1 microgram/ml in the non-PPNG group and 0.05 microgram/ml in the PPNG group . The concentration in the prostate was determined in 30 cases with benign prostatic hypertrophy . The maximum values was 52.8 micrograms/g at 15 minutes after administration of 1 g of CPR . The levels of CPR were gradually decreased with the lapse of time . The prostatic tissue concentration was 17.9 micrograms/g at 60 min., 10.1 micrograms/g at 180 min., 7.22 micrograms/g at 320 min . and 2.70 micrograms/g at 360 min . There was a positive correlation between concentration of the prostate and plasma collected at the time of the prostate . The concentration of CPR in human kidney, 90-100 min . after administration of 1 g to 4 cases with renal tumor, was 107-148 micrograms/g in the renal cortex, and 80.6-88.6 micrograms/g in the renal medulla . The concentration in kidney was higher than that in the plasma in all cases . In conclusion, CPR is suggested to be a useful drug for urological infection. Sex Transm Dis, 1991 Apr-Jun, 18(2), 80 - 3 Bacteriologic studies on Neisseria gonorrhoeae isolated in Sapporo, Japan: investigation of beta-lactamase production and auxotypes; Nishimura M et al.; The authors studied the annual incidence of isolation of penicillinase-producing Neisseria gonorrhoeae (PPNG) strains among the total number of strains of N . gonorrhoeae (1,401 strains) that were isolated in Sapporo, Japan during 1980-1989 . During the first half of the 1980s, there was a tendency for PPNG to increase, and the peak incidence was 23.9% in 1985 . Thereafter, the incidence of PPNG decreased to an isolation rate of 6.3% in 1989 . In addition, the auxotypes of 592 of 1,401 isolated strains of Neisseria gonorrhoeae were studied during three periods: 1980-1985, 1986-1987, and 1988-1989 . Among the 592 strains, 315 strains were tested for sensitivity to the action of amoxicillin . In the 1988-1989 period, the auxotype showed an increasing incidence of the auxotype that requires arginine, hypoxanthine, and uracil (i.e., AHU), whereas the proto- and pro-types decreased in incidence . The AHU strains showed higher sensitivity to amoxicillin administration compared with the proto- and pro-strains. Mol Microbiol, 1991 Apr, 5(4), 917 - 26 L-pilin variants of Neisseria gonorrhoeae MS11; Manning PA et al.; Phase- and antigenic variation of pilin expression in Neisseria gonorrhoeae is based on the genetic exchange between silent pilin genes (pilS) and the pilin expression locus (pilE) . Similarly, the non-piliated L-variants of strain MS11, which show an increased resistance to certain antibiotics, are the result of recombination with the pilE locus . However, this recombination is atypical in that pilE(L) carries a tandem arrangement of a complete pilin gene and additional partial pilin genes under the control of the same pilE promoter . Since the two pilin gene copies are tandemly arranged and are often in the same translational frame, oversized pilin molecules are produced, which do not assemble into pili . The tandem gene copies introduced in a pilE(L) locus originate from silent loci where they are already joint . Upon reversion to the P+ phenotype the L-variants lose one pilin gene copy from the pilE(L) in a process reminiscent of the deletion events that otherwise lead to the formation of the non-revertible and non-piliated Pn mutants of MS11 gonococci . Thus deletion of pilin genes from pilE can be regarded as a third mechanism of pilin variation in gonococci. Antimicrob Agents Chemother, 1991 Apr, 35(4), 622 - 6 Characterization of a gyrB mutation responsible for low-level nalidixic acid resistance in Neisseria gonorrhoeae; Stein DC et al.; Nalidixic acid-resistant derivatives of Neisseria gonorrhoeae WR302 were identified and categorized into two classes on the basis of their susceptibilities to this antimicrobial agent . The MIC of nalidixic acid for the derivative strain MUG116 was fourfold greater than that for its isogenic parental strain WR302 (2 versus 0.5 micrograms/ml, respectively) . MUG324 was significantly more resistant to nalidixic acid (greater than 64 micrograms/ml) . The MICs of other antimicrobial agents known to interact with either the gyrA or gyrB gene products were determined . Although the nalidixic acid MIC for MUG116 increased, no significant increases in the MICs of other agents that interact with the gyrA gene product were seen . The MICs of all agents that interact with the gyrA gene product were significantly increased for MUG324 . The gene that imparts low-level nalidixic acid resistance was cloned from strain MUG116 . The DNA sequence of this gene was determined, and by comparing the deduced amino acid sequence with sequences of proteins in data bases, this protein was found to be approximately 70% homologous with the gyrB gene product of Escherichia coli. Zhonghua Liu Xing Bing Xue Za Zhi, 1991 Apr, 12(2), 65 - 8 {Method of multilocus enzyme electrophoresis for typing Neisseria meningitidis serogroup A in China and it's significance in epidemiology}; Wang J; A new, more perfect taxonomic method the multilocus enzyme electrophoresis has recently been developed to type Neisseria meningitidise serogroup A strains in China isolated from 1956-1987 and to study the epidemiological relationship of the types . 183 strains could be divided into 24 ET types, among which ETs, ET18 were found predominant in epidemics occurred in last two decades respectively . Different predominant ET types were found in different epidemic period and only one predominant ET type existed in each period . The cases and carriers occurred in the interepidemic stage and in some places . Their strains belonged to some endemic ET types. Genitourin Med, 1991 Apr, 67(2), 107 - 13 The epidemiology of Neisseria gonorrhoeae isolates in Dakar, Sénégal 1982-1986: antimicrobial resistance, auxotypes and plasmid profiles; Lind I et al.; A total of 460 Neisseria gonorrhoeae isolates from patients seen at three clinics in Dakar, Senegal, 1982-1986, have been investigated . In this period a significant change in antimicrobial susceptibility was observed: the percentage of strains susceptible to penicillin (MIC less than or equal to 0.08 micrograms/ml) fell from 61 to 18 (p less than 0.0001) and the percentage of resistant strains (MIC greater than or equal to 1.2 micrograms/ml) increased from 18 to 46 . Among penicillin-resistant strains the proportion of penicillinase-producing strains (PPNG) was fairly constant (range 35-55%) . The determination of susceptibility to anti-microbial agents performed locally allowed detection of approximately all PPNG strains whereas the increase in the occurrence of strains with chromosomally determined resistance was not revealed . The study comprised 70 PPNG strains of which 19% (13/70) carried the 7.4 kb Asian plasmid and 81% (57/70) the 5.3 kb African plasmid . None of these strains possessed the 38 kb conjugative plasmid, whereas it was found in 4.5% of the 376 non-PPNG strains available for plasmid analysis; 92% (410/446) of all strains had the small 4.2 kb plasmid and 5.4% (24/446) did not contain any plasmid . Overall, auxotype zero and proline-requiring strains were predominant, accounting for 53% (244/460) and 28% (131/460), respectively . In general, PPNG strains carrying the 5.3 kb plasmid were auxotype zero (49/57 = 86%) and those carrying the 7.4 kb plasmid were proline-requiring (9/13 = 69%). Ann Emerg Med, 1991 Apr, 20(4), 351 - 4 An evaluation of clinical variables in determining the need for pelvic examination in the emergency department; Levitt MA; STUDY OBJECTIVE: To evaluate the ability of multiple clinical variables to predict an increased or decreased probability of pelvic pathology, therefore determining when a pelvic examination is needed . DESIGN: Cross-sectional . SETTING: An urban emergency department . TYPE OF PARTICIPANTS: 246 female patients presenting with abdominal pain and undergoing pelvic examination . MEASUREMENTS AND MAIN RESULTS: The patients were divided into two groups . Group 1 consisted of 99 patients without pelvic pathology (40%) and group 2 consisted of 147 patients with pelvic pathology (60%) . Pelvic pathology was defined as presence of infective discharge (with confirmation on wet mount/potassium hydroxide smear), presence of adnexal mass and/or tenderness, cervical motion tenderness, uterine enlargement and/or tenderness, blood in the vaginal vault, and culture report positive for Neisseria gonorrhea . The following variables achieved statistical significance (P less than .05) using a logistic regression model: history of vaginal discharge (odds ratio, 2.30 {95% confidence interval, 1.23 to 4.32}); history of dysmenorrhea/menorrhagia (4.35 {1.52 to 12.40}); right upper quadrant pain on physical examination (0.33 {0.13 to 0.85}); and left lower quadrant pain on physical examination or history (1.73 {0.94 to 3.19}) . CONCLUSION: History of vaginal discharge, history of dysmenorrhea/menorrhagia, and left lower quadrant pain on physical examination act as risk variables predicting presence of pelvic disease . Right upper quadrant pain on physical examination acts as a protective variable to predict absence of pelvic disease . This information may aid the emergency physician in determining the need for a pelvic examination in women with abdominal pain. Sex Transm Dis, 1991 Apr-Jun, 18(2), 119 - 23 Comparison of cefotetan plus doxycycline with cefoxitin plus doxycycline in the inpatient treatment of acute salpingitis; Walker CK et al.; Pelvic inflammatory disease (PID), one of the major sequelae of the current epidemic of sexually transmitted diseases, has been shown to be a polymicrobial infection . This study compares the efficacy and safety of two broad-spectrum combination drug regimens, cefotetan with doxycycline and cefoxitin with doxycycline, in the treatment of PID . A total of 108 patients with acute salpingitis were hospitalized and randomized into two treatment groups: cefotetan/doxycycline (N = 54) and cefoxitin/doxycycline (N = 54) . Before antibiotic administration, Chlamydia trachomatis was identified in 17 (16%) of the patients, Neisseria gonorrhoeae from 72 (67%), and anaerobic and aerobic bacteria were identified from the endometrial cultures of 86 (80%) . There were seven tubo-ovarian abscesses (TOAs) that were diagnosed in the cefotetan group, and six in the cefoxitin group . Clinical cure was achieved in 51 of 54 (94%) patients in each group . Of the six patients whose treatment failed, all had positive cultures for N . gonorrhoeae and facultative/anaerobic bacteria, whereas none had C . trachomatis . Two patients from each study arm whose treatment failed were diagnosed with TOAs and responded subsequently to clindamycin plus an aminoglycoside . Cultures that were obtained after the completion of inpatient treatment showed the eradication of C . trachomatis and N . gonorrhoeae in all patients . Also, both regimens were effective in reducing aerobic and anaerobic pathogens . Finally, both regimens were well tolerated, with few side-effects. J Bacteriol, 1991 Apr, 173(7), 2147 - 54 Transposition of Tn1545-delta 3 in the pathogenic Neisseriae: a genetic tool for mutagenesis; Nassif X et al.; The ability to study the virulence of pathogenic Neisseria spp . has been greatly limited by the absence of genetic tools which allow the construction of defined mutants . We have engineered a transposon system which allows random mutagenesis of the Neisseria genome at relatively high frequency . Tn1545-delta 3 is a 3.4-kb derivative of the gram-positive transposon Tn1545 encoding resistance to kanamycin . Tn1545-delta 3 was subcloned into an erythromycin-resistant derivative of the mobilizable shuttle vector pLES2 to yield the plasmid pMGC20 . This latter plasmid was introduced by conjugation from Escherichia coli S17-1 into Neisseria meningitidis 8013N and Neisseria gonorrhoeae 15063G . Kanamycin-resistant 8013N and 15063G transconjugants appeared at frequencies of 10(-5) and 10(-6), respectively . Restriction enzyme analysis and Southern blot hybridization of these transconjugants showed that, in Neisseria spp., the transposon excised spontaneously from pMGC20 and integrated into chromosomal DNA . Our studies revealed that (i) transposition of Tn1545-delta 3 was in numerous, apparently distinct sites, (ii) in most cases, for each transconjugant a single copy of Tn1545-delta 3 was integrated into the chromosome, and (iii) several passages on selective media did not induce secondary transposition . The kanamycin resistance marker expressed by the transconjugants was subsequently transformed into a parental background without change in the chromosomal location of the transposon . To assess the role of the general recombination system in the transposition of Tn1545-delta 3, the recA gene of N . meningitidis has been cloned and a rec derivative of 8013N has been engineered . Similar results were obtained when this latter strain was used as recipient, suggesting that recA function were not required for Tn1545-delta 3 transposition in N . meningitidis . Transposition with Tn1545-delta 3 may be an important technique for mutagenesis of the pathogenic neisseriae. Microb Pathog, 1991 Apr, 10(4), 323 - 32 Neisseria gonorrhoeae LPS variation, serum resistance and its induction by cytidine 5'-monophospho-N-acetylneuraminic acid; Demarco de Hormaeche R et al.; Inherent serum resistance and the effect of the serum resistance inducing factor cytidine 5'-monophospho-N-acetylneuraminic acid (CMP-NANA) were studied on Neisseria gonorrhoeae with different lipopolysaccharides (LPS) . Strain M01 and LPS variants of strain Gc40 (variants D1, D2, D4 and D5) were examined after incubation in the presence or absence of CMP-NANA by bactericidal assays using normal human or immune sera and by SDS-PAGE followed by silver staining or Western blotting . The blots were probed with monoclonal antibody CC1, specific to epitope C of the LPS . Variants D1 and D5 were inherently serum resistant, variants D2 and D4 and strain M01 were susceptible . CMP-NANA induced marked changes in the LPS of all gonococci . However, only some gonococci were converted to serum resistance . Gonococci which were converted to serum resistance had LPS with components of relatively large molecular mass, expressing epitope C . Variants which did not convert to serum resistance had LPS with low molecular mass components only, without epitope C . Conversion to serum resistance increased the size of the large LPS components without affecting the expression of epitope C . The results indicate that conversion to serum resistance by CMP-NANA is not a general occurrence but depends on the quality of the LPS. CMAJ, 1991 Mar 15, 144(6), 713 - 21 Predictors of chlamydial infection and gonorrhea among patients seen by private practitioners; Vincelette J et al.; OBJECTIVE: To identify the predictors of chlamydial infection and gonorrhea among patients tested by general practitioners . DESIGN: Prospective study . SETTING: General private practice, family planning and abortion clinic, adolescent clinic, sexually transmitted disease (STD) clinic and community health clinic in downtown Montreal . PATIENTS: The 2856 patients were included because of symptoms compatible with an STD, a history of sexual contact with a person known or suspected to have chlamydial infection, a history of a nonexclusive sexual relationship or presentation for an abortion . MEASURES: Patient information was obtained by the attending physician on a standard form . Enzyme immunoassay (EIA) for Chlamydia trachomatis and culture for Neisseria gonorrhoeae were performed on cervical (female) or urethral (male) samples . Stepwise logistic regression was used to identify the predictors of infection . RESULTS: The EIA results were positive in 11.1% of the cases and the culture results in 2.3% . Among the males chlamydial infection was independently associated with low age (odds ratio {OR} = 0.88 per year), heterosexuality (OR = 4.99), urethral discharge (OR = 3.74) and the absence of a history of gonorrhea (OR = 0.51) . Gonorrhea was associated with urethral discharge (OR = 24.3) and homosexuality (OR = 3.68) . Among the females chlamydial infection was associated with low age (OR = 0.79 per year), a history of sexual contact with a person known to have chlamydial infection (OR = 2.30), multiple sexual partners in the previous 12 months (OR = 1.60) and a reason for the test other than screening purposes (OR = 0.60) . Gonorrhea was associated with a reason other than screening (OR = 0.24) and low age (OR = 0.74 per year) . Among the patients tested for screening purposes age was the only significant predictor of chlamydial infection (OR = 0.79 per year), and the prevalence of gonorrhea was 0.4% . The actual rate of chlamydial infection was 11.8% among the patients younger than 25 years, 5.7% among those 25 to 34 years and 0.6% among those over 34 . CONCLUSIONS: Age alone can be used as a criterion to screen for chlamydial infection among asymptomatic patients without a history of sexual contact with a person known or suspected to have such infection and with a history of a nonexclusive relationship . The prevalence in our population justifies screening people up to 34 years of age. Immunol Today, 1991 Mar, 12(3), A29 - 33 Molecular genetics of antigenic variation; Borst P; Antigenic variation is one of the most effective strategies developed by parasites to escape immune destruction . It requires a large wardrobe of surface coats and mechanisms to exchange one coat for an unrelated one . The molecular principles of antigenic variation are now largely known in the bacterial species Borrelia and Neisseria and in the protozoa of the African trypanosome group and these three examples are discussed here by Piet Borst. Rev Infect Dis, 1991 Mar-Apr, 13(2), 216 - 8 Neisseria lactamica meningitis following skull trauma; Denning DW et al.; A woman developed meningitis due to Neisseria lactamica in association with a cribriform plate fracture . Cerebrospinal fluid antigen tests for Neisseria meningitidis were negative . The patient recovered with intravenous penicillin therapy . N . lactamica can be rapidly distinguished from N . meningitidis by the hydrolysis of ONPG (o-nitrophenyl-beta-D-galactopyranoside) . In contrast to N . meningitidis and Neisseria gonorrhoeae, N . lactamica lacks virulence properties . As 100% of N . lactamica strains are susceptible to penicillin and all three previously described patients with N . lactamica meningitis have recovered with penicillin treatment, the reason for distinguishing the organisms in this context is primarily to prevent unnecessary anxiety and prophylaxis among contacts. Clin Exp Immunol, 1991 Mar, 83(3), 430 - 7 Functionally active complement proteins C6 and C7 detected in C6- and C7-deficient individuals; Wurzner R et al.; Two sensitive sandwich ELISAs based on monoclonal antibodies directed to native C6 and C7 allowed the detection and quantitation of these complement proteins in 20 out of 37 serum samples from individuals who had previously been classified as deficient in these proteins as assessed by immunochemical and/or functional assays . Furthermore, serum from four C6-deficient and one combined C6-/C7-deficient individual showed an increase in the terminal complement complex (TCC) and a decrease in native C6 and C7 after complement activation as assayed by specific ELISAs . Despite their (incomplete) deficiencies, these individuals therefore possess functionally active terminal complement proteins with respect to their ability to generate the TCC . As these individuals have no history of a susceptibility to neisserial infections, even low concentrations of functionally active C6 and C7 may provide sufficient protection against those micro-organisms whose destruction requires TCC formation. Am J Obstet Gynecol, 1991 Mar, 164(3), 734 - 42 A randomized placebo-controlled trial of erythromycin for the treatment of Ureaplasma urealyticum to prevent premature delivery . The Vaginal Infections and Prematurity Study Group; Eschenbach DA et al.; Ureaplasma urealyticum has been associated with low birth weight and histologic chorioamnionitis and it is a frequent isolate from the chorioamnion of patients who are delivered prematurely . In prior clinical trials using antibiotics active against U . urealyticum, antibiotic treatment was associated with reduced prematurity and increased mean birth weight . In this multicenter, randomized, double-blind clinical trial, pregnant women with U . urealyticum were treated with 333 mg of erythromycin base or placebo three times daily, starting between 26 and 30 weeks' gestation and continuing through 35 completed weeks of pregnancy . Women with urinary tract infection or Neisseria gonorrhoeae infection were excluded from the trial, and women with Chlamydia trachomatis or group B streptococci were excluded from these analyses . Erythromycin did not eliminate U . urealyticum from the lower genital tract . There were no significant differences between erythromycin- and placebo-treated women in infant birth weight or gestational age at delivery, in frequency of premature rupture of membranes, or in neonatal outcome. Am J Otolaryngol, 1991 Mar-Apr, 12(2), 113 - 6 Branhamella catarrhalis and croup: toxicity in the upper respiratory tract; Dudley JP; Branhamella catarrhalis has gained increasing recognition as a pathogen in the respiratory tract . During the past 18 years, since its transfer from the genus Neisseria, it has been associated with infection in cavities of the respiratory tract (sinuses and middle ear) . It has been recognized as playing a role in laryngitis . Its isolation in large numbers from the surface and core of acutely and chronically infected tonsils indicates a possible role in these infections . Croup (two patients reported here) can now be added to this list . The toxic potential of B catarrhalis, its movement from commensal to pathogen for the upper respiratory tract, and the pathogenic mechanisms by which this has occurred are reviewed. Antimicrob Agents Chemother, 1991 Mar, 35(3), 497 - 9 Susceptibility of Neisseria gonorrhoeae to cefpodoxime: determination of MICs and disk diffusion zone diameters; Fekete T et al.; We studied the susceptibilities of 77 strains of Neisseria gonorrhoeae to four antibiotics: cefpodoxime, ceftriaxone, penicillin, and tetracycline . All strains were susceptible to ceftriaxone . Cefpodoxime MICs (range, 0.001 to 0.125 micrograms/ml) were parallel to and approximately four times those of ceftriaxone, and all strains will probably be considered susceptible to cefpodoxime . Disk diffusion zone diameters for cefpodoxime ranged from 35 to 57 mm . Of the strains, 32% were penicillin resistant and 51% were tetracycline resistant (MIC, greater than or equal to 2 micrograms/ml) . Susceptibility measurements were consistent for disk diffusion zone diameter and MIC, with an overall agreement of 215 of 225 (96%) for ceftriaxone, penicillin, and tetracycline combined . On the basis of these in vitro data, cefpodoxime should be evaluated in the treatment of gonorrhea. J Reprod Med, 1991 Mar, 36(3), 202 - 5 Role of Neisseria gonorrhoeae and Chlamydia trachomatis in intraabdominal abscess formation in the rat; Cox SM et al.; Our concept of the pathogenesis of acute salpingitis and advanced pelvic infection, such as tuboovarian abscess, is evolving . Although Neisseria gonorrhoeae and Chlamydia trachomatis are thought to play a significant role in acute pelvic inflammatory disease, other microorganisms, such as aerobes and anaerobes, have repeatedly been reported to play a significant role, also, particularly in the patient with advanced disease . A study was designed to evaluate the pathogenesis, and particularly any synergistic role, of some aerobes and anaerobes with N gonorrhoeae and C trachomatis abscess formation . Using the rat model developed by Weinstein and Onderdonk, the study demonstrated that N gonorrhoeae and C trachomatis alone do not produce abscesses . However, when combined with facultative or anaerobic bacteria, synergism with abscess formation is noted frequently . The data support the hypothesis that N gonorrhoeae and C trachomatis initiate infection and that aerobic and anaerobic bacteria act synergistically to produce abscesses . In addition, microorganisms not inoculated were found to be recruited into the infectious process . The organisms may gain access to the peritoneal cavity via the lower genital tract or from transmucosal migration from the intestinal flora. Am J Obstet Gynecol, 1991 Mar, 164(3), 849 - 58 Combination antimicrobial therapy in the treatment of acute pelvic inflammatory disease; Landers DV et al.; We compared the clinical and microbiologic efficacy of two broad-spectrum combination antimicrobial regimens in the treatment of 148 patients with acute pelvic inflammatory disease . Patients were randomized to inpatient treatment with either cefoxitin and doxycycline (n = 75) or clindamycin and tobramycin (n = 73) . These antibiotics were administered intravenously for at least 4 days, and up to 48 hours beyond defervescence . Patients were discharged on a regimen of oral doxycycline or clindamycin in accordance with the intravenous regimen to complete a total duration of therapy of 2 weeks . Neisseria gonorrhoeae (53%) and Chlamydia trachomatis (31%) were the microorganisms that were isolated most frequently from the genital tract of enrolled patients . At follow-up, N . gonorrhoeae was isolated in two patients, and C . trachomatis was isolated in none . The overall initial favorable response rate to combination antimicrobial therapy was 98.5% (130/132) in patients with uncomplicated pelvic inflammatory disease and 81% (13/16) in patients with pelvic inflammatory disease that was complicated by tuboovarian abscess . A greater than 70% decrease in abdominal tenderness score occurred in 89% of 111 patients within 6 weeks of hospital discharge . There were no significant differences between antibiotic treatment groups in any response categories or in toxicity . During the initial hospitalization, five patients (three with tuboovarian abscess; one with a pyosalpinx, and one with intractable acute and chronic pelvic inflammatory disease) required surgical intervention . These results support the recommendation to use broad-spectrum combination antimicrobial therapy for the treatment of acute pelvic inflammatory disease. Clin Ther, 1991 Mar-Apr, 13(2), 243 - 53 Epidemiology of beta-lactamases in Africa: correlation with resistance to beta-lactam antibiotics; Dowse LJ et al.; In 45 centers from eight African countries, 2,888 bacterial isolates were collected from patients with community-acquired infections . Isolated pathogens included Staphylococcus aureus (29%), Escherichia coli (20%), Neisseria gonorrhoeae (6%), Proteus species (6%), Klebsiella species (6%), Klebsiella pneumoniae (4%), and Staphylococcus epidermidis (4%) . An overall sensitivity of 16.2% was shown to penicillin G (number of isolates tested = 2,467), 31.8% to ampicillin (2,687), 45% to amoxicillin (1,959), and 84.9% to cefuroxime (2,888) . Beta-lactamase presence was measured by a chromogenic method . Beta-lactamase was found in 75% of all pathogens tested, including 69.5% of gram-negative and 83.3% of gram-positive pathogens; 73% of E coli isolates, 76% of N gonorrhoeae, 75% of Klebsiella species, and 84% of S aureus were beta-lactamase positive . Beta-lactamase presence was associated with bacterial resistance for penicillin G, ampicillin, and amoxicillin, but not cefuroxime, whose sensitivity remained high . The higher resistance rates and beta-lactamase prevalence in Africa suggest the need for national antibiotic prescribing policies and surveillance schemes and replacement of relatively ineffective penicillins with newer agents such as cefuroxime. Prostaglandins Leukot Essent Fatty Acids, 1991 Mar, 42(3), 167 - 9 Prostaglandin production by amnion and decidual cells in response to bacterial products; Mitchell MD et al.; Media from bacterial cultures have been tested for actions on prostaglandin biosynthesis by human amnion and decidual cells . The bacterial species, which are commonly associated with intrauterine infections, were Group B streptococcus, Escherichia coli, Fusobacterium nucleatum, Bacteroides fragilis, Gardnerella vaginalis, Neisseria gonorrhea, Mycoplasma hominis and Ureaplasma urealyticum . Overall, low doses of bacterial products were stimulatory of amnion prostaglandin production, whereas high doses were inhibitory . A similar pattern of results was obtained for effects on decidual prostaglandin production, although stimulatory actions at low doses were less pronounced . In all experiments interleukin 1 beta consistently induced a stimulation of prostaglandin production that greatly exceeded that caused by any bacterial product . It is possible that the inhibitory action of high doses of bacterial products on prostaglandin biosynthesis may contribute to the poor course of labor experienced by women with chorioamnionitis . Furthermore, these data lend credence to the view that the host response to infection (i.e . cytokine secretion) is the major mediator of subsequent preterm labor. Indian J Med Res, 1991 Mar, 93, 95 - 7 Microbiological evaluation of female patients in STD clinics; Iyer SV et al.; A total of 215 women patients attending the STD clinic were evaluated in an attempt to isolate the different microorganisms in sexually transmitted diseases (STD) . Mycoplasmas (30.22%), Candida species (20.00%), Trichomonas vaginalis (wet mount study; 15.81%), beta haemolytic streptococci (13.48%), Neisseria gonorrhoeae (9.30%), Staphylococcus aureus (13.95%), inclusion bodies of Chlamydia trachomatis (11.60%) and Gram negative organisms (9.30%) were isolated from these patients . Sera of all patients screened for HBsAg by ELISA showed a carrier rate of 12.5 per cent; 29.8 per cent sera were reactive in the VDRL test at the dilutions varying from 1:4 to 1:64PIP: The incidence of 10 sexually transmitted diseases (STDs) in 215 prostitutes attending a STD clinic was determined by culture and other standard techniques . A control group of 100 women attending an outpatient family planning clinic in L.T.M . Medical College, Bombay, matched for age and socioeconomic level was the reference . The organisms assayed, the percent of study group found positive, and the percent of controls found positive were: M . hominis, 11.2 and 0.0%; U . urealyticum, 19.1 and 12.0%; Candida to species level, 20.0 and 70.%; beta-hemolytic streptococci, 13.5 and 3.0%; group B streptococci, 6.7 and 0.0%; T . vaginalis, 15.8 and 3.0%; C . trachomatis (by inclusion bodies), 11.6 and 1.0%; coagulase-positive S . aureus, 13.95 and 5.0%; N . gonorrhoeae, 9.3 and 0.0%; and Gram negative bacteria, 9.3 and 1.0% . The VDRL (Venereal Disease Reference Laboratory) seropositivity was 29.5% in STD patients . HBsAG (hepatitis B surface antigen) were present in 12.5% . Most of the women had vaginitis, cervicitis, vulvitis or warts with secondary infections . These incidence rates were discussed relative to several other Indian surveys . J Infect Dis, 1991 Mar, 163(3), 460 - 3 Cytomegalovirus infection in sexually active adolescents; Sohn YM et al.; To determine whether cytomegalovirus (CMV) infection in teenage girls is related to sexual activity, 254 girls 12-18 years old (mean, 15.8) attending a contraceptive counseling clinic were studied . Participants were screened for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, and serum antibody to CMV was determined . Demographic and sexual history data were collected by interview . The mean number of lifetime sex partners was 2.2; 173 (68%) were seropositive . Race, greater than 3 years of sexual activity, and greater than 2 lifetime sex partners were significant risk factors for CMV infection (odds ratios {OR}, 1.8-4.7; P less than .05) . Using logistic regression analysis, a composite sexual activity variable was the most important risk factor for CMV infection (OR, 4.8; P = .003), followed by race (OR, 3.4; P = .004) and a sexually transmitted disease composite variable (OR, 2.4; P = .016) . Sexual activity is an important risk factor for CMV infection in adolescent girls. Clin Exp Immunol, 1991 Mar, 83(3), 413 - 7 Human hybridomas derived from CD5+ B lymphocytes of patients with chronic lymphocytic leukemia (B-CLL) produce multi-specific natural IgM (kappa) antibodies; Jahn S et al.; Great numbers of CD5+ B lymphocytes were detected in the peripheral blood of patients with B-CLL . To study the antibody repertoire of this immune cell subpopulation on a monoclonal level, we fused the lymphocytes derived from five different donors to a highly efficient HAT-sensitive heteromyeloma line (CB-F7) . A fusion frequency of up to 10(-5) allowed us to analyse hundreds of initial hybridoma lines per fusion . In all culture supernatants in three out of five fusions IgM lambda antibodies were detected, in two experiments only IgM kappa was measured, suggesting monoclonality of the primary hybridoma cell lines . The later fusions resulted in hybridomas producing multi-specific antibodies against both an autoantigen and an infectious agent: (i) dsDNA/influenza virus haemagglutinin; (ii) dsDNA/class V outer membrane protein type C from Neisseria meningitidis . However, no antibodies of the described specificity were detected in blood sera of patients, indicating a 'switch-on' of the immunoglobulin secretion capacity of malignant B cells during fusion to a myeloma partner . We discuss the results as further evidence for the natural multi-reactive antibody repertoire of CD5+ B cells. Antimicrob Agents Chemother, 1991 Feb, 35(2), 300 - 4 Penicillin-resistant isolates of Neisseria lactamica produce altered forms of penicillin-binding protein 2 that arose by interspecies horizontal gene transfer; Lujan R et al.; Isolates of Neisseria lactamica that have increased resistance to penicillin have emerged in recent years . Resistance to penicillin was shown to be due to the production of altered forms of penicillin-binding protein 2 (PBP 2) that have reduced affinity for the antibiotic . The sequences of the PBP 2 genes (penA) from two penicillin-resistant isolates were almost identical (less than or equal to 1% sequence divergence) to that of a penicillin-susceptible isolate, except in a 175-bp region where the resistant and susceptible isolates differed by 27% . The nucleotide sequences of these divergent regions were identical (or almost identical) to the sequence of the corresponding region of the penA gene of N . flavescens NCTC 8263 . Altered forms of PBP 2 with decreased affinity for penicillin in the two penicillin-resistant isolates of N . lactamica appear, therefore, to have arisen by the replacement of part of the N . lactamica penA gene with the corresponding region from the penA gene of N . flavescens. J Immunol, 1991 Feb 1, 146(3), 1052 - 6 Reduced C8 beta messenger RNA expression in families with hereditary C8 beta deficiency; Warnick PR et al.; Individuals with functional C8 beta deficiency are at increased risk for systemic neisserial infections . Studies by others have shown that the structural gene for this protein appears intact in deficient individuals . We studied affected individuals from 10 unrelated families to determine the basis for their defect . Using chain-specific antisera, C8 beta was undetectable on immunoblots of their sera . The polymerase chain reaction was used to probe cDNA synthesized from RNA isolated from human liver cells, HepG2 cells, peripheral blood monocytes, and fibroblasts to identify a readily available cell source expressing C8 beta message . Cells from each of these sources expressed C8 beta message . The identity of the amplified product was confirmed and this approach was used to probe cDNA synthesized from RNA harvested from monocytes or fibroblasts obtained from two unrelated families with C8 beta deficiency . C8 beta mRNA was readily detectable in C8 beta sufficient and heterozygous family members but required Southern blotting and hybridization to the 32P-labeled C8 beta probe for detection in the homozygous deficient probands . These results suggest that C8 beta-deficient individuals produce less C8 beta-specific mRNA than do normals and that the underlying basis for this deficiency is an abnormality in intracellular events that precede secretion. Zh Mikrobiol Epidemiol Immunobiol, 1991 Feb, (2), 51 - 4 {A radioimmunological method for determining IgA-class antimeningococcal secretory antibodies in human saliva}; Krasnoproshina LI et al.; The data on the content of secretory IgA antibodies to group A Neisseria meningitidis protein antigen in the saliva of persons, both having had contact with N . meningitidis culture and having had no such contact, are presented . The results were obtained by the method of radioimmunoassay, developed specially for the determination of N . meningitidis protein antigen. J Clin Pathol, 1991 Feb, 44(2), 169 - 70 Laboratory detection of ciprofloxacin resistant Neisseria gonorrhoeae; Turner A et al.; During 1989 and 1990 strains of Neisseria gonorrhoeae with reduced susceptibility to ciprofloxacin were isolated in laboratories across the United Kingdom . Treatment failures were associated with some of these infections . These strains were detected by quantitative susceptibility testing because the zone of inhibition around 5 micrograms ciprofloxacin discs shows little decrease in size even with those that are the most resistant . This study determined that strains with reduced susceptibility to ciprofloxacin (MIC of greater than or equal to 0.05 mg/l) produced no zone of inhibition around a commercially available disc containing 30 micrograms of nalidixic acid . Ciprofloxacin sensitive (MIC of less than 0.05 mg/l) strains, however, grew with a large zone (greater than 21 mm) around this disc . These observations suggest that laboratories could adopt this disc test to detect those strains for which ciprofloxacin is not appropriate treatment. Pathol Biol (Paris), 1991 Feb, 39(2), 136 - 9 {In vitro activity of an antiseptic, chlorquinaldol, against Neisseria gonorrhoeae and Chlamydia trachomatis}; Corrihons I et al.; The activity of chlorquinaldol, a derivative of hydroxy-8-quinolein used for local antisepsy, was studied against Neisseria gonorrhoeae and Chlamydia trachomatis . The weak solubility of the product and the special growth conditions of the organisms made an adaptation of the AFNOR norm necessary . For 0.1 to 0.2% (W/V) chlorquinaldol concentrations, a reduction of about 10(4) organisms was obtained after 60 minutes for N . gonorrhoeae and C . trachomatis . However, for technical problems, the concentrations tested were 10 to 100 times lower than the doses usually recommended for this antiseptic. Mol Cell Probes, 1991 Feb, 5(1), 49 - 54 Evaluation of a DNA probe of plasmid origin for the detection of Neisseria gonorrhoeae in cultures and clinical specimens; Torres MJ et al.; This study evaluates a cryptic plasmid-derived DNA probe in a dot-blot hybridization assay of 4-h duration, using both known bacterial isolates and clinical specimens . The probe, consisting of a 237 bp segment of the plasmid-encoded gene cppB, sequences of which are also found in the chromosome, was labelled with digoxigenin-11-dUTP . The sensitivity of the probe was approximately 25 pg of DNA or 500 cfu of Neisseria gonorrhoeae . A total of 170 reference strains of Neisseria gonorrhoeae and other related bacteria were tested for reactivity with the probe . All N . gonorrhoeae strains, including three plasmid-free strains, hybridized with the probe . Among the heterologous bacterial cultures, only one strain of N . cinerea reacted with the probe when the cell concentration was 5 x 10(6) cfu . The probe was also evaluated in a clinical study . A total of 201 patients visiting the STD clinic at the University Hospital, University of Seville, participated in the study . The sensitivity of the assay was 95% while the specificity was 98% . Positive and negative predictive values were 97% and 98%, respectively . It appears that the plasmid-derived probe used in this study could serve as a useful tool in the rapid and specific detection of Neisseria gonorrhoeae in clinical specimens. J Clin Microbiol, 1991 Feb, 29(2), 363 - 6 Interpretive criteria and quality control guidelines for Neisseria gonorrhoeae susceptibility test standardization for cefotetan; Jones RN et al.; Cefotetan was tested in a multilaboratory study to standardize susceptibility testing criteria and quality control guidelines for Neisseria gonorrhoeae . Cefotetan was most active against penicillinase-producing and penicillin-susceptible strains (MIC for 50% of strains tested, 0.5 micrograms/ml) and was least active against the chromosomally resistant isolates (MIC for 50% of strains tested, 2 micrograms/ml) . The recommended 30-micrograms disk cefotetan interpretive criteria were as follows: susceptible at greater than or equal to 26 mm (less than or equal to 2 micrograms/ml), intermediate at 20 to 25 mm (4 micrograms/ml), and resistant at less than or equal to 19 mm (greater than or equal to 8 micrograms/ml) . Quality control guidelines for agar dilution and disk diffusion tests were established by using numerous GC agar lots, three cefotetan 30-micrograms disk lots, two quality control organisms, and a volume of tests consistent with National Committee for Clinical Laboratory Standards M23-T guidelines. Infect Immun, 1991 Feb, 59(2), 732 - 6 Identity between polysaccharide antigens of Moraxella nonliquefaciens, group B Neisseria meningitidis, and Escherichia coli K1 (non-O acetylated); Devi SJ et al.; A surface polysaccharide antigen of Moraxella nonliquefaciens, reported to be cross-reactive with the capsular polysaccharides of group B Neisseria meningitidis and Escherichia coli K1 (K . Blvre, K . Bryn, O . Closs, N . Hagen, and L . O . Froholm, NIPH Ann . 6:65-73, 1983), was isolated, purified, and characterized chemically, immunologically, and by nuclear magnetic resonance . This polysaccharide was shown to be a linear homopolymer of alpha (2----8)-linked N-acetylneuraminic acid, identical to the capsular polysaccharide of group B N . meningitidis and O-acetyl-negative variants of E . coli K1. Genomics, 1991 Feb, 9(2), 290 - 7 Nonsporulating bacterial species contain DNA sequences homologous to the Bacillus spore-specific C-protein gene; Vocero-Villeta AM et al.; Genes for small, acid-soluble spore proteins (SASPs) are ubiquitous among the spore-forming bacteria and are expressed only during sporulation . Although they perform the function of amino acid storage in spores, the members of the SASP-C multigene family probably serve additional functions, so that similar sequences might be present in non-spore-formers . Using the SASP-C gene (ssp-c) as a hybridization probe, restriction digests of whole genomic DNA from seven nonsporulating bacterial species were examined for similar sequences . Hybridization was found in four species: Streptococcus pyogenes, Staphylococcus aureus, Neisseria sicca, and Mycobacterium phlei, indicating the presence of similar sequences in some, but not all, of the non-spore-formers . In each of these positive species, multiple bands hybridized . A 4.5-kb hybridizing fragment from S . pyogenes and a 9.0-kb hybridizing fragment from M . phlei have been cloned and partially sequenced . These fragments show substantial DNA sequence homology to ssp-c and their deduced amino acid sequences show substantial homology to SASP-C. Proc Natl Acad Sci U S A, 1991 Feb 1, 88(3), 1029 - 33 FKB1 encodes a nonessential FK 506-binding protein in Saccharomyces cerevisiae and contains regions suggesting homology to the cyclophilins; Wiederrecht G et al.; FK 506, a powerful immunosuppressant that blocks allograft rejection by preventing T-cell activation, binds to an 11-kDa protein called the FK 506-binding protein (FKBP) . Like cyclophilin, a cytosolic protein that binds another immunosuppressant, cyclosporin A, FKBP possesses peptidylprolyl cis-trans isomerase activity . We have isolated a genomic clone encoding the yeast FKBP (FKB1) . The gene encodes a protein of 114 amino acids having a calculated Mr of 12,158 . Disruption of the gene shows that FKB1 is not essential for growth . A search of translated nucleic acid data bases revealed bacterial FKBP homologs in Neisseria meningiditis and Pseudomonas aeruginosa . Comparison of the conserved amino acids in FKBP homologs with the conserved amino acids in the cyclophilins has revealed a region of similarity that we speculate to be a homologous domain related to the functional similarities of the two proteins. Behring Inst Mitt, 1991 Feb, (88), 194 - 9 Evasion mechanisms of pathogenic Neisseriae; Meyer TF; The outcome of the early stages of a neisserial infection is determined by receptor-mediated events that culminate in the attachment and invasion of human mucosal tissues . The factors participating in this process, including pili, opacity proteins (Opa), and perhaps lipopolysaccharide (LPS), undergo phase and antigenic variation allowing the pathogens to evade the human immune response . In addition antigenic variation is essential in the modulating pathogen host cell interactions . Likewise the production of distinct Opa proteins allows the bacteria to enter epithelial cells and thereby to escape the humoral host responses . Other mechanisms including antigenic mimicry by capsular polysaccharides and antigenic masquerade by immunoglobulin fragments confer additional resistance to the extracellular life style of these organisms . Finally alpha-protein, a putative hormone-like factor produced by pathogenic Neisseriae, may contribute to the complex evasion-program of these species. Enferm Infecc Microbiol Clin, 1991 Feb, 9(2), 95 - 7 {Multicenter study of the Rosco-Neisseria system for the identification of pathogenic neisserias and Branhamella catarrhalis}; Perez JL et al.; The commercial Rosco-Neisseria system was evaluated in the identification of 228 oxidase-positive Gram-negative diplococci and it was compared with conventional tests . The procedure detects gamma-glutamyl aminopeptidase, ONPG, tributyrin hydrolysis, and sensitivity to the disk of 10 micrograms of colistin . A correct identification was obtained in the 65 strains of Neisseria gonorrhoeae, the 33 of N . meningitidis, the 12 of N . lactamica, and the 56 of B . catarrhalis . The method was also able to discriminate 54 out of the 62 strains of nonpathogenic Neisseria . However, the 7 strains of Neisseria polysaccharea and one strain of N . subflava biovar perflava were erroneously identified as N . gonorrhoeae . None of the latter was superoxol positive in contrast with the 100% of cases of gonococcal strains . The Rosco-Neisseria system is simple and inexpensive but it should be applied on specimens that grow on selective media for gonococci (such as Thayer-Martin and others) and it should be complemented by superoxol test. Mol Microbiol, 1991 Feb, 5(2), 279 - 87 Pilin expression and processing in pilus mutants of Neisseria gonorrhoeae: critical role of Gly-1 in assembly; Koomey M et al.; Spontaneous mutants of Neisseria gonorrheae failing to express pili or having diminished levels of piliation were studied with regard to pilin expression . All mutants displayed altered pilin processing detectable as the release of soluble, truncated pilin molecules (S-pilin) . Of particular interest was the finding, in one mutant, that substitution of serine for glycine at position -1 of propilin, a highly conserved residue among N-metPhe and related pilins, abolished pilus expression but not S-pilin release . The degree of S-pilin processing and the levels of membrane-associated pilin varied among the different classes of mutants, suggesting that each was blocked at a distinct step of pilus biogenesis . The data support a model in which increased S-pilin processing is a result of a decreased rate of pilus polymerization. EMBO J, 1991 Feb, 10(2), 477 - 88 Phase variation of gonococcal pili by frameshift mutation in pilC, a novel gene for pilus assembly; Jonsson AB et al.; Pili prepared from Neisseria gonorrhoeae contain minor amounts of a 110 kd outer membrane protein denoted PilC . The corresponding gene exists in two copies, pilC1 and pilC2, in most strains of N.gonorrhoeae . In the piliated strain MS11(P+), only one of the genes, pilC2, was expressed . Inactivation of pilC2 by a mTnCm insertion resulted in a nonpiliated phenotype, while a mTnCm insertion in pilC1 had no effect on piliation . Expression of pilC was found to be controlled at the translational level by frameshift mutations in a run of G residues positioned in the region encoding the signal peptide . Nonpilated (P-), pilin expressing colony variants that did not express detectable levels of PilC were selected; all P+ backswitchers from these P-, PilC- clones were found to be PilC+ . The structural gene for pilin, pilE, was sequenced and found to be identical in one P-, PilC- and P+, PilC+ pair . Most PilC- cells were completely bald whereas the PilC+ backswitcher had 10-40 pili per cell . Thus, a turn ON and turn OFF in the expression of PilC results in gonococcal pili phase variation . These results suggest that PilC is required for pilus assembly and/or translocation across the gonococcal outer membrane. Biochemistry, 1991 Jan 22, 30(3), 851 - 7 Three-dimensional structural analysis of the group B polysaccharide of Neisseria meningitidis 6275 by two-dimensional NMR: the polysaccharide is suggested to exist in helical conformations in solution; Yamasaki R et al.; The solution conformations of the group B polysaccharide of Neisseria meningitidis were analyzed by DQF-COSY and pure absorption 2D NOE NMR with three mixing times . The pyranose ring of the sialic acid residue was found to be in the 2C5 conformation . The DQF-COSY analysis indicated that the orientations of H6 and H7 and of H7 and H8 are both gauche . In order to overcome the difficulties in analyzing the NOE data due to the two sets of proton overlaps, molecular modeling of alpha-2,8-linked sialic acid oligomers was carried out to investigate possible conformers, and theoretical NOE calculations were performed by using CORMA (complete relaxation matrix analysis) . Our analysis suggests that the polysaccharide adopts helical structures for which the phi (defined by O6-C2-O8-C8) and psi (C2-O8-C8-C7) angles are in the following ranges: phi -60 to 0 degrees, psi 115-175 degrees or phi 90-120 degrees, psi 55-175 degrees . The weak affinity of anti-B antibodies for smaller alpha-2,8-linked oligosaccharides may be due to the fact that such oligomers are more flexible and may not form an ordered structure as the poly(sialic acid) does. Ugeskr Laeger, 1991 Jan 21, 153(4), 284 - 8 {Neonatal conjunctivitis after the abolition of compulsory Credé prophylaxis}; Gadeberg OV et al.; The prescript requiring application of silver nitrate eye drops (0.66% AgNO3) to the conjunctivae of the newborn within two hours after delivery was revoked in March 1985 . The present study comprises a prospective investigation of the occurrence of microorganisms in specimens of eye secretion from neonates received during the period February-April 1986, and a review of findings of Neisseria species and B . catarrhalis in 3,485 specimens of ocular secretions and of C . trachomatis in 1,240 conjunctival scrapes received at the Neisseria Department 1986-1988 . The numbers of cases of conjunctivitis neonatalis caused by the following microorganisms were: N . gonorrhoeae 8, N . cinerea 6, other Neisseria species 8, B . catarrhalis 49 and C . trachomatis 92 . During the period 1984-1988, the total number of neonates with gonococcal conjunctivitis neonatalis was 18 . The gonococcal infection was diagnosed within the first week of life in 50% of the cases but could occur as late as in the fourth week of life . Similarly, infection with B . catarrhalis was most common in neonates less than one week old (49%), whereas chlamydial infection was most common in the second week of life (39%) . It is concluded that the eyes of neonates should be carefully observed for at least four weeks and that microbiological examinations for gonococci and chlamydia are indicated if signs of infection appear. Sex Transm Dis, 1991 Jan-Mar, 18(1), 28 - 35 Unsuspected Chlamydia trachomatis infection in heterosexual men attending a sexually transmitted diseases clinic: evaluation of risk factors and screening methods; Rietmeijer CA et al.; To characterize the problem of unsuspected Chlamydia trachomatis infection in heterosexual men attending a sexually transmitted diseases (STD) clinic, the authors assessed risk factors for infection and the value of screening for infection by gram-stained smears and urinalysis in 438 men who did not have conventional clinical indications for chlamydial treatment at their initial visit . Evaluations included urethral swabs for gram-stained smears and Neisseria gonorrhoeae and C . trachomatis cultures and microscopy of first-catch urine sediment . C . trachomatis was isolated from 29 subjects (6.6%) and N . gonorrhoeae from 6 subjects (1.3%), (P less than .05) . The only demographic or clinical factors that were associated with C . trachomatis were age younger than 21 years and five or more lifetime sexual partners . Screening for C . trachomatis with urethral gram stain and urine sediment examination had sensitivities of only 23% and 35%, respectively . Risk factor assessment and screening with standard microscopic procedures do not adequately predict infection in this group, which accounts for almost 25% of the C . trachomatis burden in heterosexual men who visit an STD clinic . More specific chlamydia detection methods are needed for effective control programs. Arch Gynecol Obstet, 1991, 249(2), 95 - 101 The effect of ciprofloxacin and doxycycline plus metronidazole on lower genital tract flora in patients with proven pelvic inflammatory disease; Miettinen A et al.; Alterations in the lower genital tract flora were studied during antimicrobial treatment of 36 women with acute pelvic inflammatory disease (PID) . Sixteen women received ciprofloxacin, and 20 received doxycycline plus metronidazole . Both regimes eradicated Chlamydia trachomatis in all cases and Neisseria gonorrhoeae in all except one in which combination treatment failed because of resistance of the organism to tetracycline . Both regimes eradicated Mycoplasma hominis in all cases, while ciprofloxacin was somewhat less effective than combination treatment against Ureaplasma urealyticum . Ciprofloxacin was less effective than combination treatment against Gardnerella vaginalis . The incidence of Candida infection increased equally in both groups, although symptoms necessitating antifungal treatment were rare. NAACOGS Clin Issu Perinat Womens Health Nurs, 1991, 2(3), 313 - 21 Abnormal bleeding associated with reproductive tract infection; French JI; Reproductive tract infection is an often unrecognized, but relatively common, cause of abnormal reproductive tract bleeding . Postcoital bleeding, menorrhagia, metrorrhagia, and oral contraceptive break-through bleeding are potentially infection-related complaints . The microorganisms most often associated with abnormal reproductive tract bleeding include: Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus type 2, and microorganisms associated with bacterial vaginosis . The clinical conditions cervicitis, endometritis, and pelvic inflammatory disease and the related microorganisms are discussed, as are strategies for clinical management and counseling. Bull Soc Pathol Exot, 1991, 84(2), 136 - 44 {Analysis of 190 strains of Neisseria gonorrhoeae isolated in Yaounde from 1984 to 1987: auxotypes, plasmidic contents, antibiotic sensitivity}; Abong BT et al.; Gonococcal infections are always a public health problem in Cameroon . From January 1984 to December 1987, 2,074 strains have been isolated in the "Centre Pasteur du Cameroun" . Among these strains, 190 had been studied in details concerning antibiotic susceptibility, auxotypes and plasmidic content . Penicillinase producing Neisseria gonorrhoeae (PPNG) were increasingly isolated: 32.28% (1984); 59.57% (1987) . Auxotypes prototrophes and proline requiring were more often isolated . Plasmidic content showed essentially african type (with or without conjugative plasmid) but also asian type. Biol Met, 1991, 4(2), 126 - 31 Characterization of a soluble ferric reductase from Neisseria gonorrhoeae; Le Faou AE et al.; An NADH-dependent ferric reductase was identified in extracts of Neisseria gonorrhoeae . Enzyme activity was measured in an assay using ferrozine as the ferrous iron acceptor . Ferric reductase activity was enhanced by Mg2+ and flavine nucleotides . The enzyme reduced both citrate- and diphosphate-bound ferric iron as well as ferric hydroxide (Imferon) . However, no activity was observed with either 30%-iron-saturated transferrin or with the gonococcal iron-binding protein, Fbp . The ferric reductase was found primarily within the cytoplasmic cell fraction . The soluble ferric reductase was purified 110-fold by ammonium sulfate precipitation, gel and anion-exchange chromatography . Results obtained following gel chromatography and SDS/polyacrylamide gel electrophoresis suggested that the enzyme had a molecular mass of about 25 kDa. Kansenshogaku Zasshi, 1991 Jan, 65(1), 77 - 87 {A study on the beta-lactamase production for Neisseria gonorrhoeae and the sensitivity to various antibacterial agents}; Nishimura M et al.; During the 10-year period from 1980 through 1989 using gonococci isolated in Sapporo, we studied beta-lactamase production capacity and the sensitivity of various antibacterial agents and obtained the following results . 1 . The frequency of isolating beta-lactamase producing gonococci (PPNG) displayed a gradual tendency to increase during the first half of the 80's and reached a peak in 1985 of 23.9% (61/255) . However, thereafter it tended to decline and in 1989 it was 6.3% (2/32) . 2 . The sensitivity to penicillin-type antibacterial agents was higher against PPNG than non-PPNG against PCG, ABPC, and AMPC displaying about a 7 level MIC90 so that it was quite sensitive . Against CVA/AMPC, SBTPC it showed a relatively favorable MIC90 . Also, the sensitivity of PPNG against AMPC with 1984 as the boundary, thereafter the MIC distribution was observed to decline somewhat . 3 . Against the monobactam-type injectable drug, AZT, both non-PPNG and PPNG showed a low MIC distribution and against SPCM both showed a relatively high MIC distribution of 3.13-25 micrograms/ml . 4 . In regard to the sensitivity to cephem-type antibacterial agents, against such 3rd generation injectables as CZX, CFTM-PI, etc . it displayed a particularly low MIC distribution . 5 . Against tetracycline and macrolide antibacterial agents, it displayed a relatively high MIC distribution . 6 . Against new quinolone type antibacterial agents, regardless of being non-PPNG or PPNG, it showed a low MIC. Sex Transm Dis, 1991 Jan-Mar, 18(1), 5 - 9 Gonorrhea in women prostitutes: clinical data and auxotypes, serovars, plasmid contents of PPNG, and susceptibility profiles; Vazquez F et al.; Eighty-nine women prostitutes who underwent clinical and microbiologic examination were found to have gonococcal infection . The median age was 22; 92.1% were from urban areas . Nearly all the women prostitutes refrained from barrier methods (92.1%) and had contact with several partners (91.0%) . The most frequent clinical findings were leukorrhea (50.6%), cervicitis (20.2%), and pelvic inflammatory disease (PID) (18.0%) . Eighty-one women prostitutes (93.1%) had experienced a previous STD, with Chlamydia trachomatis (34.8%), Trichomonas vaginalis (30.3%), Neisseria gonorrhoeae (29.2%), and Ureaplasma urealyticum (23.6%) as the most frequent microorganisms isolated . Microorganisms associated with N . gonorrhoeae were isolated, mainly T . vaginalis (40.4%), C . trachomatis (31.5%), and Mycoplasma hominis (21.3%) . For N . gonorrhoeae, the most frequent auxotypes were prototrophic (67.4%) and Proline (Pro)-dependent (14.6%); 2.2% of the strains were non-auxotypable . Beta-lactamase production was detected in three strains (3.4%) belonging to the auxotype/serovar: Lys/IA, Prototrophic/IB, and Pro/IB . The two former produced the 3.2-MDa "African" plasmid; the latter produced two plasmids (the 4.5-MDa "Asian" and the 24.5-MDa transfer plasmid. Sex Transm Dis, 1991 Jan-Mar, 18(1), 18 - 20 Evaluation of ofloxacin in the treatment of uncomplicated gonorrhea; Smith BL et al.; In an open study, a single oral dose of 400 mg of ofloxacin was administered to 40 men and 20 women who required treatment for uncomplicated gonococcal infection . Thirty-six men and 13 women were evaluable . Ofloxacin eradicated 49 of 49 urethral or endocervical gonococcal infections and 1 of 1 pharyngeal infection . There were 55 pretreatment isolates of Neisseria gonorrhoeae available for antimicrobial susceptibility testing . Twenty-four (43.6%) produced penicillinase . Eighteen (32.7%) isolates that did not produce penicillinase had penicillin MICs greater than or equal to 1.0 micrograms/mL . Twelve (21.8%) isolates had tetracycline MICs greater than or equal to 16 micrograms/mL . The geometric mean minimal inhibitory concentrations (range) for 55 pretreatment N . gonorrhoeae isolates were: ofloxacin, 0.014 (.0078-.03) micrograms/mL; penicillin, 6.30 (.125-128) micrograms/mL; and tetracycline 1.61 (.03-128) micrograms/mL . There were few side effects . Ofloxacin appears to be an effective and safe oral therapy for the treatment of infections caused by N . gonorrhoeae including infections due to penicillin- and tetracycline-resistant strains. Vaccine, 1991 Jan, 9(1), 60 - 6 Immunogenicity in adult males of a Neisseria meningitidis group B vaccine composed of polysaccharide complexed with outer membrane proteins; Lifely MR et al.; Twenty five adult male volunteers were given a vaccine composed of the capsular B polysaccharide non-covalently complexed to serotype 6 outer membrane proteins (OMP) of Neisseria meningitidis . Subjects were divided into three dose groups receiving 50, 100 or 150 micrograms vaccine in aluminium hydroxide in each of three injections spaced 4 weeks apart . Systemic signs/symptoms considered clinically significant were recorded on 6% (4/70) of occasions and were succeeded by withdrawal of two volunteers from the study . Local injection site reactions, mostly mild to moderate, were reported after all vaccinations with one such reaction leading to a third volunteer withdrawing from the study . Geometric mean anti-B responses before immunization and 1 week after the third immunization (9 weeks) were 3.60 and 7.12 micrograms ml-1 in the 50 micrograms group (p less than 0.05) 2.05 and 12.19 micrograms ml-1 in the 100 micrograms group (p less than 0.001), and 3.68 and 14.20 micrograms ml-1 in the 150 micrograms group (p less than 0.001) . The anti-B response was predominantly of the IgM isotype and persistence above prevaccination levels was evident for at least 12 months . Anti-type 6 OMP responses were also evidenced with geometric mean multiplicative increases over prevaccination levels at 9 weeks and 6 months of 7.8 and 4.2 for the 50 micrograms group, 11.6 and 5.6 for the 100 micrograms group and 6.8 and 3.4 for the 150 micrograms group . The bulk of this response was of the IgG isotype . Passive protection of mice was achieved with both pre- and post-vaccination (9 weeks; 100 and 150 micrograms groups) pools of sera.(ABSTRACT TRUNCATED AT 250 WORDS) Ethiop Med J, 1991 Jan, 29(1), 27 - 35 Community-wide outbreak of Neisseria gonorrhoeae conjunctivitis in Konso district, North Omo administrative region; Mikru FS et al.; We describe a large outbreak of severe pustular conjunctivitis due to Neiserria gonorrhoeae . Over 9,000 cases occurred during 8 months in 1987-1988 in one district in North Omo, Ethiopia . Both sexes and all age groups were affected, particularly children under 5 years of age; only a small minority were neonates . Despite a highly successful cure rate for individual cases, the outbreak continued for a number of months . Several epidemiologic approaches were used to monitor the outbreak and identify the mechanism of transmission . The epidemic curve suggested person-to-person transmission . Routine surveillance data showed that there was no concurrent genital gonorrhea outbreak and genital transmission could not explain a community-wide outbreak . In the setting of intense crowding and relative lack of water, peak transmission of illness coincided with two periods following the rains, suggesting that flies were important in transmission . A case-control study identified lack of face-washing as a household risk factor . Eighty seven of one-hundred and forty six (59%) control houses with children were judged to contain children with clean faces, while only 102 of 216 (47%) case households contained children with clean faces (p less than .05) . Our recommendations include measures to improve personal hygiene. J Med Microbiol, 1991 Jan, 34(1), 23 - 7 4-Quinolone-resistant Neisseria gonorrhoeae in the United Kingdom; Gransden WR et al.; The auxotype, serogroup and antimicrobial susceptibility of 977 clinical isolates of Neisseria gonorrhoeae obtained at St Thomas' Hospital, London, during 1989 were determined; 23 isolates from 15 patients were resistant to 4-quinolones . Twelve of the patients acquired their infection in the UK and these strains were generally sensitive to other antimicrobial agents; strains from 10 patients were of serogroup IB-6 . Three patients acquired their strains outside the UK and these isolates were multi-resistant and of different serogroups. Am J Emerg Med, 1991 Jan, 9(1), 77 - 80 Retropharyngeal space infections in a community hospital; Gradon JD et al.; The emergency physician often has to deal with infectious disease emergencies . The authors have seen four cases of retropharyngeal infection of potentially life-threatening severity in less than 1 year, all were admitted through the emergency department (ED) . Reporting these cases is important to increase awareness among emergency physicians of this classic disease entity . The characteristics of the patients are discussed including initial diagnostic approaches and the use of computed tomography (CT) scanning of the neck and mediastinum . One case of retropharyngeal space infection caused by Neisseria meningitidis serotype W-135 is described . This is the first such reported case . The recommendations are that, in the absence of overt focal infection, a non-surgical approach to the treatment of these patients is indicated . This should include suitable neck roentgenograms, CT scanning, and high-dose, intravenous, beta-lactamase-resistant antibiotics. World Health Forum, 1991, 12(1), 63 - 6 A partnership in epidemiological research; Fox E et al.; Four medical research teams completed ten epidemiological investigations in Djibouti and thus provided the country's Ministry of Health with valuable information on infectious disease risks . A major factor contributing to the success of the work was the high degree of cooperation between the Ministry, a United States naval medical research unit, and the World Health Organization as coordinatorPIP: Epidemiologic research has the potential to complement public health technical assistance programs and to provide health planners with information on priority areas for intervention . This potential was documented in Djibouti, where a US naval medical research unit conducted 10 epidemiologic investigations preliminary to the planning of a national acquired immunodeficiency syndrome (AIDS) control program . Data were collected on human immunodeficiency virus (HIV) prevalence and incidence in high-risk populations, the comparative performance of HIV screening assays, attitudes and practices relevant to sexually transmitted diseases, viral hepatitis markers, the prevalence of arboviral infections, the nature and drug susceptibility of microbial pathogens associated with infectious diarrhea and Neisseria gonorrhoea, the epidemiology of malaria, and the ecology of sandflies in relation to human leishmaniasis . These findings were utilized in the setting of priorities and the planning of disease control measures . Baseline epidemiologic data are now available, and national research capabilities have been strengthened so that further research on AIDS , malaria, and diseases such as leishmaniasis can be conducted . The success of this experience was in large part due to the cooperation and coordination between the research unit, the Ministry of Health, and a World Health Organization Collaborating Center on AIDS . Mol Microbiol, 1991 Jan, 5(1), 137 - 48 Control of pilus expression in Neisseria gonorrhoeae as an original system in the family of two-component regulators; Taha MK et al.; We have previously reported the identification of two genes, pilA and pilB, which act in trans to regulate pilus expression in Neisseria gonorrhoeae . Here we show that PilA and PilB have amino acid sequence similarities with members of the two component 'sensor-regulator' family of proteins . PilB has homology with histidine kinase sensors . Alkaline phosphatase fusions to the predicted sensor and transmitter domains are described . Their PhoA activity and cellular location suggest that PilB is inserted in the cytoplasmic membrane and predict periplasmic and cytoplasmic locations for the sensor and the transmitter domains, respectively . PilA has homology with response regulators in its N-terminal part, and with components of the eukaryotic protein secretory apparatus (SRP 54 and SRP receptor) as well as two Escherichia coli gene products in its C-terminal part . In particular, it contains a putative GTP-binding site . Mini-transposon insertions into different regions of pilA were obtained . The phenotypes and genotypes of these mutants and preliminary biochemical studies of the gene products of two of these mutants lend further support to the hypothesis that PilA is a DNA-binding response regulator and confirm that it participates in an essential function in the bacterium. Arch Inst Pasteur Tunis, 1991 Jan-Apr, 68(1-2), 27 - 31 {Sensitivity of Neisseria gonorrhoeae to antibiotics}; Kechrid A; Since 1976 strains of Neisseria gonorrhoeae producing beta-lactamase have been isolated in many countries . Strains with high level resistance to tetracycline have been also described . The appearance of resistant strains implies a constant surveillance of the isolated gonococcus and the study of their antibiotics sensitivity. Zentralbl Gynakol, 1991, 113(11), 613 - 23 {Salpingitis}; Hoyme UB; The etiology of salpingitis is polymicrobial, however, the particular pathogen is difficult to identify, even in laparoscopically obtained specimens . Chlamydia trachomatis, Neisseria gonorrhoeae, anaerobes and facultative anaerobic bacteria have to be covered by antimicrobial therapy . This article reviews the current aspects of etiology, diagnosis, therapy, prevention and complications of salpingitis. Przegl Epidemiol, 1991, 45(3), 183 - 9 {Meningitis and encephalitis in the years 1983-1990 . Clinical observations}; Kepa L et al.; From 1983 to 1990, at the I Clinic of Infectious Diseases, Silesian Academy of Medicine in Bytom, 995 patients with meningitis and encephalitis were treated; the average age was 17.86 years . After cerebrospinal fluid (CSF) examinations the patients were divided into groups . The first group consisted of patients with suppurative meningitis and encephalitis (202-20.30%), the other group were patients with aseptic meningitis (309-31.06%), a separate group consisted of patients with mumps meningitis (484-48.06% cases) . In the group with suppurative meningitis and encephalitis etiological agents were isolated (Gram stain smear and/or culture of CSF) in 50.99% of cases . The most common causes of suppurative neuroinfections were: Neisseria meningitides and Streptococcus pneumoniae (in 23.76% cases) . The increasing number of bacteriological tests positive results was observed during the analyzed period . The etiology of aseptic inflammation diseases of the central nervous system was defined with the help of serologic blood tests in 10-15%, and serologic confirmation of mumps meningitis was as high as 80% of cases . In the group of purulent neuroinfections, during the 8-year observation, 36 deaths occurred (17.82% of these patients) . The observed tendency of the death rate decrease is concerned to be a result of better microbiological diagnostics and the possibility of an early aimed antibiotic therapy. Reprod Fertil Dev, 1991, 3(6), 743 - 6 Screening for Neisseria gonorrhoeae and Chlamydia trachomatis in a donor insemination programme; Haddad Y et al.; Cultures of all 4450 specimens of semen from 193 semen donors were negative for N . gonorrhoeae . A MicroTrak direct fluorescence microscopy test for the detection of Ch . trachomatis was used to screen 448 specimens from all 268 recipients of semen on an insemination programme for 3 1/2 years; all pre-insemination endocervical samples and all subsequent endocervical samples were negative . It is considered that the incidence of gonorrhoeae or chlamydia in our recipients or donors is very low . Fluorescence microscopy is a specific and cost-effective screening technique for Ch . trachomatis. J Clin Microbiol, 1991 Jan, 29(1), 70 - 5 Binding of S protein by Neisseria gonorrhoeae and potential role in invasion; Arko RJ et al.; An agglutination assay was used to examine the binding of purified human S protein (vitronectin, serum spreading factor) to 201 clinical isolates of Neisseria gonorrhoeae . Strains belonging to the protein IA serovars were significantly (P less than 0.001) more reactive in agglutination tests with human S protein and were more serum resistant than strains belonging to the protein IB serovars . The strains from patients with disseminated infections belonged predominantly to the IA serovar (19 of 23) and, with the exception of IA-4 and certain IB serovars, avidly agglutinated with S protein . The serovar IA-4 and IB strains isolated from joint or cerebrospinal fluid failed to agglutinate with S protein and appeared to be less serum resistant than most other IA isolates . Cysteine hydrochloride or 2-mercaptoethanol inhibited agglutination of S protein and a more than twofold increase in resistance to killing by fresh human serum following preincubation with S protein; the serum-sensitive parent strain did not agglutinate S protein, and serum resistance was not increased following preincubation with this protein . Binding of S protein by gonococci may represent a novel pathogenic mechanism that can contribute to serum resistance. AIDS, 1991, 5 Suppl 1, S183 - 91 Condom issues in AIDS prevention in Africa; Lamptey P et al.; PIP: In vitro studies have demonstrated that an intact latex condom provides an effective barrier against several sexually transmitted pathogens, including herpes simplex virus type 2, hepatitis B virus, cytomegalovirus, HIV, Neisseria gonorrhea, Chlamydia trachomatis, and mycoplasma . This paper discusses some of the major advances and critical issues which should be incorporated in condom program design and implementation . The authors drew extensively from their experience with Family Health International's AIDSTECH Project with 21 targeted HIV prevention programs in 14 African countries . The programs are designed primarily to reach high-risk behavior groups among whom the virus is most prevalent . The authors observe from their work that a number of social, economic, political, and cultural obstacles impede greater condom use in Africa; private sector initiatives which recruit members of target populations to be key personnel in project implementation show promise for reaching high-risk behavior groups; condom logistics systems remain a weak link in condom distribution programs; rising costs and inadequate sources of latex condoms are problematic; and alternatives to the male latex condom could be commercially available by 1992 . Sections discuss barriers to condom use, new approaches in condom distribution, condom quality assurance, condom costs and economics, and technological advances in condoms . Pharm Weekbl Sci, 1990 Dec 14, 12(6A), 268 - 74 Gynaecological infections and strategies for treatment; Roex AJ; Frequently, encountered gynaecologic infections and pathogens involved are presented . A review is given of bartholinitis, vulvovaginitis-bacterial vaginosis, candidiasis, trichomoniasis cervicitis and pelvic inflammatory disease: Neisseria gonorrhoeae, Chlamydia trachomatis and herpes simplex virus 2 . Of each infection a thorough description of clinical symptoms and diagnostic criteria is followed by up-to-date treatment advices . For vulvovaginitis, cervicitis and pelvic inflammatory disease antifungal and antimicrobial agents, route of administration, the required daily dosage and time of administration are presented in an overview table. J Immunol Methods, 1990 Dec 5, 134(2), 215 - 25 Comparison of methods for the analysis of outer membrane antigens of Neisseria meningitidis by western blotting; Davies RL et al.; The method of extraction of outer membrane proteins (OMPs), the conditions of electrophoretic transfer, and the